At A New Hope Psychiatric Services, we are committed to providing clear and transparent information about costs, insurance coverage, and fees. Please review the following policies, which apply to all clients. A full Financial Policy is provided and signed at intake.

Payment Information

• A valid credit card on file is required to schedule and attend appointments.

• Payment is due on the day of service.

• Charges are automatically processed within 1 hour of the appointment start time.

• Accepted payment methods: Debit Cards and Credit Cards (Visa, MasterCard).

• All fees listed below apply regardless of whether services are billed to insurance or self-pay.

Self-Pay Service Rates

Psychiatric Services

• Initial Psychiatric Evaluation (1 hour): $250

• Medication Management / Follow-Up (30 minutes): $125

• Medication Refills Only: $75 (must be discussed with the provider before applying and requires approval from administration)

Therapy Services

• Therapy Sessions (1 hour): $150

Psychological Evaluations

• $250 per 60 minutes

• Minimum 2 hours required ($500 minimum fee)

• Cash pay only (not billable to insurance)

Insurance & Reimbursement

• Insurance coverage depends on eligibility and verification before your appointment.

• Required paperwork must be submitted at least 48 business hours in advance.

• Clients are responsible for all costs not covered by insurance, including co-pays, deductibles, co-insurance, and denied claims.

• Claims are submitted as a courtesy, but final coverage decisions are made by your insurance carrier.

• Any administrative, cancellation, or same-day fees apply in addition to insurance coverage and remain the client’s responsibility.

Same-Day Appointment Fees

• New Appointments: +$100

• Follow-Up Appointments: +$75

• This fee is an additional charge applied on top of regular service fees (whether billed to insurance or paid out-of-pocket).

• This surcharge is not covered by insurance and is always the responsibility of the client.

• Same-day appointments are subject to provider availability and not guaranteed.

Forms & Administrative Fees

• Medical Records Requests (Florida Statute §456.057):

  • $1.00 per page for the first 25 pages

  • $0.25 per page thereafter

  • Applies to both printed and electronic records

  • Fee must be paid before records are released

• Administrative Forms (FMLA, Disability, Complex Paperwork, etc.):

  • $50.00 per page

  • Maximum fee of $200.00 for 8 or more pages

  • Payment required before form completion

• School/Work Notes:

  • Free during appointments

  • $25.00 if requested outside an appointment

Note: These fees are not covered by insurance and are always the responsibility of the client.

Cancellation & No-Show Policy

• Cancellations must be made at least 48 business hours before the appointment.

• Late Cancellations/No-Shows:

  • Established Patients: $100

  • New Patients: $150

• A one-time waiver may be granted if the appointment is rescheduled and kept within 7 days.

• These fees are not covered by insurance and must be paid directly by the client.

• This is a summary. The full Cancellation & No-Show Policy is provided and reviewed with all clients during intake.

Good Faith Estimate (No Surprises Act)

If you are uninsured or paying out-of-pocket, you have the right to receive a Good Faith Estimate of expected costs before services are provided.

For more information, visit: www.cms.gov/nosurprises.

Additional details are included in the Good Faith Estimate Policy provided at intake.

Acknowledgment

By receiving services at A New Hope Psychiatric Services, you acknowledge that you have reviewed and understand this Financial Policy and accept responsibility for all fees.

Disclaimer

All fees and policies are subject to change, with advance notice provided when legally required.

Last Updated: September 18, 2025